Tag: Billing

From: CMS MLN Articles – 2/26/16

Provider Action Needed

Change Request (CR) 9549 describes changes to and billing instructions for various payment policies implemented in the April 2016 OPPS update. The April 2016 Integrated Outpatient Code Editor (I/OCE) and OPPS Pricer will reflect the Healthcare Common Procedure Coding System (HCPCS), Ambulatory Payment Classification (APC), HCPCS Modifier, and Revenue Code additions, changes, and deletions identified in CR9549. The I/OCE update is in CR9553. Upon release of that CR, an MLN Matters article (MM9553) related to the updated I/OCE will be posted on the Centers for Medicare & Medicaid Services (CMS) website. Make sure your billing staffs are aware of these changes.

Update of OPPS – April 2016

From: MLN Connects Provider eNews – 5/28/15

As a result of the recent passing of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, Medicare Administrative Contractors (MACs) will be mass adjusting all Federally Qualified Health Center (FQHC) claims billed under the Prospective Payment System (PPS) with dates of service on or after April 1, 2015, through May 3, 2015.

Mass Adjustment of FQHC PPS Claims

From: MLN Matters – MM8997 Revised – 4/3/15

Provider Action Needed:

Change Request (CR) 8997 updates sections of the “Medicare Benefit Policy Manual” and the “Medicare Claims Processing Manual” in regards to SNF policy and billing. If you provide services to Medicare beneficiaries in a SNF stay, information in CR8997 could impact your payments.

Read more: Updated to Medicare Internet-Only Manual for SNF Providers